The 4th of February is World Cancer Day, and in advance of this in 2024 the WHO’s cancer agency, the International Agency for Research on Cancer (IARC), shared the latest estimates on the global burden of cancer. Alongside this WHO published survey results from 115 countries, which identify inadequate financing for priority cancer and palliative care services within universal health coverage (UHC). The IARC estimates highlight that the burden of cancer is growing, disproportionately affecting underserved populations.
In 2022 there were an estimated 20 million new cancer cases and 9.7 million deaths. The estimated number of people who were alive within 5 years of a cancer diagnosis was 53.5 million.
“About 1 in 5 people develop cancer in their lifetime; approximately 1 in 9 men and 1 in 12 women die from the disease.”
Key threats
The data in IARC’s Global Cancer Observatory reveal that 10 types of cancer collectively comprised around two-thirds of new cases and deaths globally in 2022. The data cover 185 countries and 36 cancers.
Lung cancer was the most commonly occurring cancer with 2.5 million new cases, which account for 12.4% of the total new cases. Behind lung cancer, female breast cancer caused 2.3 million cases, 11.6% of the total, and colorectal cancer caused 1.9 million cases, 9.6% of the total. Prostate cancer caused 1.5 million cases and stomach cancer 970,000 cases.
Lung cancer was the leading cause of cancer death, causing 1.8 million deaths and representing 18.7% of the total cancer deaths. WHO suggests that the re-emergence of lung cancer as the most common cancer is related to “persistent tobacco use in Asia”. This was followed by colorectal cancer with 900,000 deaths, 9.3%, and liver cancer with 760,000 or 7.8%.
For women, the most diagnosed cancer and leading cause of cancer death was breast cancer. Breast cancer was also the most common cancer in women in most countries (157 out of 185). In men it was lung cancer. The second and third most commonly occurring cancers in men were prostate and colorectal cancers. For women, lung and colorectal cancer were second and third.
Cervical cancer was the eighth most commonly occurring cancer globally and the ninth leading cause of cancer death; it accounted for 661,004 new cases and 348,186 deaths. It was the most common cancer for women in 25 countries, particularly in sub-Saharan Africa. Although WHO recognises “varying incidence levels”, it calls for elimination of cervical cancer as a public health problem through scale-up of the WHO Cervical Cancer Elimination Initiative.
Persistent inequity
The data and global estimates indicate that there are “striking inequities in the cancer burden according to human development”, particularly for breast cancer. For countries with a “very high” HDI, 1 in 12 women will be diagnosed with breast cancer and 1 in 71 will die of it. In comparison, in countries with “low” HDI, 1 in 27 women is diagnosed with breast cancer but 1 in 48 will die from it.
Dr Isabelle Soerjomataram, Deputy Head of the Cancer Surveillance Branch at IARC explains why there is this variation:
“Women in lower HDI countries are 50% less likely to be diagnosed with breast cancer than women in high HDI countries, yet they are at a much higher risk of dying of the disease due to late diagnosis and inadequate access to quality treatment.”
WHO’s global survey of UHC and cancer found that only 39% of participating countries covered the “basics of cancer management” in financed core health services for all citizens, or health benefit packages (HBPs). Lung cancer-related services were reportedly 4-7 times more likely to be incorporated in HBPs in a high-income country than a lower-income country.
There was an average four-fold greater likelihood of radiation services being covered in an HBP of a high-income country than a lower-income country. However, the “widest disparity” for any service was stem-cell transplantation, which was 12 times more likely to be included in the HBP of a high-income country than a lower-income country.
Dr Bente Mikkelsen, Director of the Department of Noncommunicable Diseases at WHO, believes that the survey “sheds light on major inequalities and lack of financial protection for cancer around the world”. Populations in lower-income countries are “unable to access the basics of cancer care”.
“WHO, including through its cancer initiatives, is working intensively with more than 75 governments to develop, finance, and implement policies to promote cancer care for all. To expand on this work, major investments are urgently needed to address global inequities in cancer outcomes.”
A worrying future
The estimates also look ahead to 2050, with over 35 million new cancer cases predicted in a 77% increase from the estimated 20 million cases in 2022.
“The rapidly growing global cancer burden reflects both population ageing and growth, as well as changes to people’s exposure to risk factors, several of which are associated with socioeconomic development.”
For example, tobacco, alcohol, and obesity are “key factors” behind the increasing incidence of cancer, alongside air pollution, which is a “key driver of environmental risk factors”. High HDI countries are expected to see the greatest absolute increase in incidence, but the proportional increase is “most striking” in low HDI countries. In these countries, cancer mortality is “projected to almost double in 2050”.
Dr Freddie Bray, Head of the Cancer Surveillance Branch at IARC commented on this uneven increase.
“Those who have the fewest resources to manage their cancer burdens will bear the brunt of the global cancer burden.”
Dr Cary Adams, head of the Union for International Cancer Control, recognised that progress has been made in the “early detection of cancers and the treatment and care of cancer patients”. However, there are “significant disparities in cancer treatment outcomes”, not only between countries but within countries.
“Where someone lives should not determine whether they live. Tools exist to enable governments to prioritise cancer care, and to ensure that everyone has access to affordable, quality services. This is not just a resource issue but a matter of political will.”
We look forward to considering how vaccines can contribute to global cancer management ambitions at the Congress in Washington this April. Do join us to contribute to the discussion and learn from experts in the field or subscribe for more insights here.
